What Is Malignant Hypertension (Hypertensive Emergency)?

What is a
hypertensive emergency?

Hypertension, or high blood pressure, is a common condition. It affects 1 in 3 Americans adults, according to the Centers for Disease Control and Prevention.

Guidelines for diagnosing and treating high blood pressure from the American College of Cardiology and American Heart Association have recently changed. Experts now predict that nearly half of American adults will have high blood pressure.

High blood pressure is generally manageable if you follow your doctor’s advice.

Although it’s not common, some people with high blood pressure may have a rapid rise in blood pressure above 180/120 millimeters of mercury (mm Hg). This is known as a hypertensive crisis.

If a person with a blood pressure of 180/120 mm Hg or higher also has new symptoms — especially those related to the eye, brain, heart, or kidney — this is known as a hypertensive emergency. Hypertensive emergencies were previously known, in some cases, as malignant hypertension.

A hypertensive emergency requires immediate medical attention. Symptoms indicate that organ damage is occurring. If you don’t get emergency treatment, you may develop serious health problems, such as:

What
are the symptoms of a hypertensive emergency?

High blood pressure is commonly referred to as the “silent killer.” This is because it doesn’t always have obvious signs or symptoms. Unlike moderate high blood pressure, a hypertensive emergency has very noticeable symptoms. Symptoms can include:

What
causes a hypertensive emergency?

Hypertensive emergencies mostly occur in people with a history of high blood pressure. It’s also more common in African-Americans, males, and people who smoke. It’s especially common in people whose blood pressure is already above 140/90 mm Hg. According to a 2012 clinical review, about 1 to 2 percent of people with high blood pressure develop hypertensive emergencies.

Some health conditions increase your chances of having a hypertensive emergency. These include:

If you have high blood pressure and develop any changes in your normal symptoms, seek immediate medical attention. Also seek immediate medical attention if you develop new symptoms related to a hypertensive emergency.

How is a
hypertensive emergency diagnosed?

Your doctor will ask you about your health history, including any treatments you’re on for high blood pressure. They’ll also measure your blood pressure and discuss any symptoms you’re currently having, such as changes in vision, chest pain, or shortness of breath. This will help your doctor determine whether or not emergency treatment is needed.

Determining organ damage

The BUN test measures the amount of waste product from the breakdown of protein in the body. Creatinine is a chemical produced by the breakdown of muscles. Your kidneys clear it from your blood. When the kidneys aren’t functioning normally, these tests will have abnormal results.

How
is a hypertensive emergency treated?

A hypertension emergency can be life-threatening and requires immediate medical attention. You need to get treatment for it immediately in order to safely lower your blood pressure and avoid dangerous complications.

Treatment typically includes using high blood pressure medications, or antihypertensive medications, given intravenously, or through an IV. This allows for immediate action. You’ll typically require treatment in the emergency room and intensive care unit.

Once your blood pressure stabilizes, your doctor will prescribe oral blood pressure medications. These medications will enable you to control your blood pressure at home.

If you receive a diagnosis of a hypertensive emergency, you’ll need to follow your doctor’s recommendations. This will include having regular checkups to monitor your blood pressure and continuing to take your medications on a regular basis.

How
can a hypertensive emergency be prevented?

Some cases of hypertensive emergencies can be prevented. If you have high blood pressure, it’s important for you to check your blood pressure regularly. It’s also important for you to take all prescribed medications without missing any doses. Try to also maintain a healthy lifestyle and follow your doctor’s advice.

Make sure to treat any ongoing health conditions that may put you at risk for a hypertensive emergency. Seek immediate treatment if you develop any symptoms. You’ll need urgent care to help reduce organ damage.